Getting to a Healthy Weight, One Good Choice at a Time

Like most women, weight has always been a sensitive topic for me. My mother says I was a greedy breastfeeder. As a toddler I’d lick my plate and ask for seconds. Adolescence brought on more cravings and less willpower, and adulthood hasn’t been any easier.

I love to eat much too much, and, darn it, eating too much means weighing too much. Weight loss has been a struggle my whole life. I’ve lost and gained hundreds of pounds; my closet has clothes from size 14 down to 4. Some attempts were halfhearted and some were zealous — but almost all fizzled out after a few months with my goal unmet.

I found exercise beyond boring and had great trouble finding the time to do it. Plus, it was hard to give up my glass of wine (and the cheese and crackers that immediately follow) as a reward at the end of my 15-hour work days. Rarely, after getting to my goal weight, did I have the freedom to eat what I wanted. But then BAM, within a short period of time, the pounds climbed back on requiring a rapid return to dieting.

For me, weight management has been mostly about looking good, feeling confident, and getting into my clothes. All that (and everything else) changed a year ago with my own breast cancer diagnosis. This huge wake-up call became a major motivator. What was a hobby became an important job essential to reducing my risk of recurrence. I lost 15 pounds — and gained back 5 — and have held tight at 10 pounds down.

What worked for me was getting real about what matters most: how much I eat. I’ve had to avoid overeating, stay out of the kitchen, not bring tempting foods into the house, limit alcohol, cook real food, eat out less (plus less take-out food), and exercise 5 hours per week. Zumba is the only exercise that works for me because it combines three things that I like: Latin music, dance, and social interaction. It’s fun and aerobic and doesn’t feel like work. I also protect the quality of my sleep: no caffeine after 1 p.m., no late-night phone calls, heavy curtains are up in the bedroom, and my husband’s snoring is better managed. Truly a personal lifestyle transformation.

Too bad it took a breast cancer diagnosis to light the fire under me. Today, the medical consensus is that weight gain after age 18 increases the risk of breast cancer after menopause. There is also some evidence that gaining weight after diagnosis can increase the risk of recurrence. With the obesity epidemic sweeping the country, there is more reason for concern.

Being overweight increases risk because fat cells make estrogen; extra fat cells mean more estrogen in the body, and estrogen can make hormone-receptor-positive breast cancers develop and grow. Many of the hormonally active chemicals in the environment are stored in body fat. Plus, when you’re overweight, you tend to exercise less and eat more unhealthy foods. The good news is that there is also some evidence that losing excess weight can lower that increased risk of breast cancer.

Research shows that more than 64% of American adult women are overweight or obese. Losing weight is HARD. Losing weight after 50 is even HARDER. I know. I’ve tried, failed, and ultimately succeeded. But if you’ve been diagnosed with breast cancer and you want to do everything you can to live cancer-free, you have to get serious about weight management. Even if you haven’t been diagnosed, maintaining a healthy weight throughout your life is an excellent way to help keep your risk of breast cancer as low as it can be. No more fooling around.

But no matter how compelling the reasons are to manage your weight, it’s still hard to get enthusiastic about losing weight. It’s easy to get stuck in a rut of negativity. Believing you can’t do it if past attempts have failed can sink your plan. Even if you have a great plan, sticking to it over time may be your biggest challenge. Like me, you may be taking a hormonal therapy medicine such as tamoxifen, which can increase your appetite, making it even harder to control your food cravings. Regardless of our past challenges and current reasons and excuses, everyone can find ways to manage their weight more effectively with sound advice and practical guidance.

Talk to your doctor about a healthy weight for you based on your age, your height, your body type, and how active you are. Tell your doctor the kinds of things you can and can’t do and the things that you like and don’t like doing. And be open to being more active!

Sometimes success can depend on how you think about losing weight: make weight management a top priority, learn the steps that give you the biggest bang for your buck, change your feelings and attitudes about hurdles in your path, and be open to trying new things (and cutting out or curbing bad habits).

Here are some examples. You can turn progress into failure with a common misconception: eating and exercise are equally important for weight loss. In fact, 80% of weight loss is what you eat and drink. Unless you’re a marathon runner or a spinning maniac, only about 20% relates to exercise. Don’t get caught thinking they’re 50/50 partners: a 400-calorie slice of cheesecake that takes 5 minutes (or less) to eat would take hours walking on the treadmill to burn off. You also have to be prepared to give up cooking methods that may be part of your family traditions (like deep-fried chicken or adding cheese and butter to all your vegetables) and change old seemingly harmless habits (like tasting while you cook or eating raw dough when you bake). Still, exercise is critically important. It builds muscle, keeps your resting metabolic rate elevated, and lessens cravings.

It’s important to be open to new foods, including those that you’re sure you hate (like the tomatoes, brussels sprouts, or fish you might have hated as a kid). Give them another chance as an adult. There are so many healthy options out there that will help you accomplish your goals. Once you get your game on, you’ll feel so much better.

You can’t wave a magic wand or eat one food that will make you lose weight and keep the weight off. Eating only grapefruit, lemonade, or cabbage soup for a month may help you shed some pounds, but chances are it will come right back on when you start eating other foods again. Portion size can make all the difference — especially for rich foods that you only eat once in awhile.

Getting started is the hardest part. But there are highs and lows. Be encouraged by the first few pounds you lose in the first 1-2 weeks. After that it can be struggle for some people because the weight’s not coming off as fast anymore. But keep at it. More weight loss and feeling lighter and better give you additional necessary positive reinforcement to keep you on course. You can read more tips on the Breast Cancer Risk Factors: Being Overweight page and get support from other members of the BCO community at the Fitness and Getting Back in Shape and Healthy Recipes for Everyday Living discussion boards.

Marisa Weiss, M.D. is the founder, president, and chief medical officer of Breastcancer.org, the world's most trafficked online resource for medically reviewed breast health and breast cancer information, reaching over 14 million visitors per year. A breast cancer oncologist with over twenty years of active practice in the Philadelphia region, Dr. Weiss is regarded as a visionary advocate for her innovative and steadfast approach to informing, empowering, and treating patients with breast cancer.

Comments

Lindissima says:

Marisa,

I really appreciate this blog entry. I will reread it periodically to keep my motivation up as I continue on my quest for weight loss. You’re right; it’s not easy, especially after menopause and once you are on hormone therapy. But I have been pleasantly surprised to see that it is possible. I have lost 40 pounds over the past 6 months by exercising regularly and monitoring my food intake daily.
Articles like yours help to make me even more determined to get the weight off in order to be healthy and decrease my risk for recurrence..

ibcmets says:

Dr. Marisa Weiss,
Thank you so much for creating breastcancer.org. This site has been the best resource that I read daily about breastcancer. I’m an avid reader & contributor of this site and found so much helpful information as I’m an ibc stage IV breast cancer survivor.

My PS is greatly encouraging me to lose weight due to my hormonal status of being ER/PR+. Being overweight has always been a dilemma for me. I need to remind myself daily that losing weight is something that needs to done, not just a preference for me.